Heart failure is most often a long-term (chronic) condition, but it may come on suddenly. It can be caused by many different heart problems.

The condition may affect only the right side or only the left side of the heart. More often, both sides of the heart are involved.

Heart failure is present when:

Your heart muscle cannot pump (eject) the blood out of the heart very well. This is called systolic heart failure, or heart failure with a reduced ejection fraction (HFrEF).

Your heart muscle is stiff and does not fill up with blood easily. This is called diastolic heart failure, or heart failure with a preserved ejection fraction (HFpEF).

As the heart's pumping becomes less effective, blood may back up in other areas of the body. Fluid may build up in the lungs, liver, gastrointestinal tract, and the arms and legs. This is called congestive heart failure.

The most common causes of heart failure are:

Coronary artery disease (CAD), a narrowing or blockage of the small blood vessels that supply blood and oxygen to the heart. This can weaken the heart muscle over time or suddenly.

High blood pressure that is not well controlled, leading to problems with stiffness, or eventually leading to muscle weakening.

Symptoms of heart failure often begin slowly. At first, they may only occur when you are very active. Over time, you may notice breathing problems and other symptoms even when you are resting. Symptoms may also appear suddenly after the heart is damaged from a heart attack or other problem.

Common symptoms are:

Cough

Fatigue, weakness, faintness

Loss of appetite

Need to urinate at night

Pulse that feels fast or irregular, or a sensation of feeling the heartbeat (palpitations)

Shortness of breath when you are active or after you lie down

Swollen (enlarged) liver or abdomen

Swollen feet and ankles

Waking up from sleep after a couple of hours due to shortness of breath

Weight gain

Treatment

MONITORING AND SELF CARE

If you have heart failure, your provider will monitor you closely. You will have follow-up visits at least every 3 to 6 months, but sometimes much more often. You will also have tests to check your heart function.

Weight gain, especially over a day or two, can be a sign that your body is holding on to extra fluid and your heart failure is getting worse. Talk to your provider about what you should do if your weight goes up or you develop more symptoms.

Limit how much salt you eat. Your provider may also ask you to limit how much fluid you drink during the day.

Stay active. Walk or ride a stationary bicycle. Your provider can provide a safe and effective exercise plan for you. DO NOT exercise on days when your weight has gone up from fluid or you are not feeling well.

Get enough rest, including after exercise, eating, or other activities. This allows your heart to rest too.

MEDICINES, SURGERY, AND DEVICES

You will need to take medicines to treat your heart failure. Medicines treat the symptoms, prevent your heart failure from getting worse, and help you live longer. It is very important that you take your medicine as your health care team directed.

These medicines:

Help the heart muscle pump better

Keep your blood from clotting

Lower your cholesterol levels

Open up blood vessels or slow your heart rate so your heart does not have to work as hard

Reduce damage to the heart

Reduce the risk of abnormal heart rhythms

Replace potassium

Rid your body of excess fluid and salt (sodium)

It is very important that you take your medicine as directed. DO NOT take any other drugs or herbs without first asking your provider about them. Drugs that may make your heart failure worse include:

At a certain point, the provider will decide whether it is best to keep treating heart failure aggressively. The person, along with his or her family and doctors, may want to discuss palliative or comfort care at this time.

When to Contact a Medical Professional

Call your provider if you develop:

Increased cough or phlegm

Sudden weight gain or swelling

Weakness

Other new or unexplained symptoms

Go to the emergency room or call the local emergency number (such as 911) if:

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).